KEITH A MOSS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

ACTIVE

Business

First Name

KEITH

Middle

Last Name

MOSS

Suffix

Business Name

KEITH A MOSS MD

Original Issue Date

01/18/2002

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2023